She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Hydroxychloroquine and phototherapy Aralen malaria doses Plaquenil arthritis medication Chloroquine phosphate brooklynella Other pathologies encountered by a neuro-ophthalmologist which may result in thinning of the macula OCT or disruption of the photoreceptor structure include hydroxychloroquine Plaquenil toxicity, and other retinopathies disrupting the photoreceptor layer, including retinitis pigmentosa 16, 17. Many systemic medications may cause retinal toxicity. One such commonly used medication for dermatologic and rheumatologic inflammatory conditions is hydroxychloroquine Plaquenil, a chloroquine derivative. It is used to treat many diseases including malaria, rheumatoid arthritis and systemic lupus erythematosus. Hydroxychloroquine, sold under the brand name Plaquenil Sanofi-Aventis, is an antimalarial drug that has gained widespread use in treating various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. 1 By some estimates, more than 150,000 patients are on long-term therapy with this medication in America alone. 2 Retinal toxicity associated with HCQ use is. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Plaquenill oct macula Hydroxychloroquine Plaquenil Toxicity and Recommendations., Hydroxychloroquine-Induced Retinal Toxicity - American. Plaquenil use icd 10 codeDoes hydroxychloroquine always help when taking methotrexatePlaquenil malaria preventionChloroquine casIs hydroxychloroquine a painkiller Plaquenil, hydroxychloroquine HCQ, is an anti-malarial medication that has been proven to be useful in the treatment of patients with rheumatoid arthritis RA, systemic lupus erythematosus SLE and other inflammatory and autoimmune diseases. The Risk of Retinal Toxicity with Plaquenil. Multimodal Imaging in Plaquenil Toxicity. Eye screening for patients taking hydroxychloroquine.. Recent advances in spectral-domain optical coherence tomography SD-OCT allow for cross-sectional imaging of the retina in vivo to resolutions of 5 to 10 μm. 11 – 16 Adaptive optics AO imaging corrects for ocular aberrations and allows for direct visualization of the photoreceptor mosaic in vivo to resolutions of ≤2 μm. 17 – 20 This report presents the results of SD-OCT and AO imaging on two patients with known hydroxychloroquine retinopathy. SD-OCT is capable of detecting characteristic macular changes of HCQ toxicity. These typical macular abnormalities include loss of the parafoveal ellipsoid zone EZ, parafoveal thinning of the outer nuclear layer ONL and inner plexiform layer IPL, the “flying saucer” sign, and peripapillary nerve fiber layer thinning 12 – 14. Screening Tests The primary screening tests are automated visual fields plus spectral-domain optical coherence tomography SD OCT. These should look beyond the central macula in Asian patients. These should look beyond the central macula in Asian patients.